Earlier this month, the vocal powerhouse announced via a series of tweets that the remainder of U.S. dates on her Piece by Piece tour had to be canceled, as she was ordered to go on vocal rest. “I can’t wait to get healthy and see y’all back on the road soon,” she posted. “I hate canceling and I am truly sorry to my fans that have been excited to see this show. Please know that I never cancel anything unless it’s absolutely necessary.”

And it’s now medically necessary to cancel the Canada and U.K. dates, as well. Clarkson was supposed to start a 10-city run in Canada tonight, followed by six November dates across the pond.

“I was so looking forward to sharing this tour with all my amazing fans in Canada and the UK,” she writes in a note to fans on her website. “Unfortunately my doctor is telling me I have to stay on vocal rest, but I am working hard to get better as fast as possible.”

Clarkson has actually been battling vocal problems for more than a year now. She revealed to Entertainment Tonightearlier this year that she lost her voice after the June 2014 birth of her daughter. “I literally had a moment where I cried and drank wine all day,” she said. “I was like, ‘Oh, God, I’m not going to be a singer anymore!’ I was bawling to my husband and like, completely hammered, just going, ‘Oh my God, it’s over. I don’t know what I’m going to do.”

But she recovered, releasing her Piece by Piecealbum in March and kicking off its namesake tour in July. She announced in the middle of an August concert that she is expecting her second child.